对化疗不敏感肝母细胞瘤肺转移患儿手术治疗的中期结局

Mid-termsurgical outcomes of pulmonary metastasis of chemotherapy-insensitive hepatoblastoma

目的探讨儿童肝母细胞瘤肺转移的手术时机、手术方法及中期结局。方法回顾性分析2012年1月至2016年12月我院收治的37例肝母细胞瘤肺转移患儿的临床资料及随访资料。其中男27例,女10例,患儿手术时年龄13~124个月,手术时年龄中位数36个月,均采用常规开胸手术切除。结果共行肺转移瘤切除术37例/54次,其中25例(67.57%,25/37)患儿仅实施1次手术,二次手术8例(21.62%,8/37),三次手术3例(8.11%,3/37),四次手术1例(2.70%,1/37)。手术均取得成功,围手术期死亡2例,术后随访2~6年,无事件生存15例,死亡15例,其2年总体生存率(Overall survival,OS)为59.5%(22/37),2年无事件生存(Event-free Survival,EFS)率为40.5%(15/37)。结论化疗不敏感的肝母细胞瘤肺转移患儿能够从手术中获益,但手术时机需进一步探讨。

Objective To explore the operative timing,approaches and mid-term outcomes of pulmonary metastasis of hepatoblastoma in children.Methods From January 2012 to December 2016,clinical and follow-up data were retrospectively analyzed for 37 children with pulmonary metastasis of hepatoblastoma.There were 27 boys and 10 girls with a median age of 36(13-124)months.Routine thoracotomy was performed.Results A total of 54 pulmonary metastatic tumor resections were performed.And the frequency was one(67.57%,25/37),two(21.62%,8/37),three(8.11%,3/37)and four(2.70%,3/37).Overall survival(OS)rate was 59.5%(22/37)and 2-year event-free survival(EFS)rate 40.5%(15/37).Conclusions Chemotherapy-insensitive children with pulmonary metastasis of hepatoblastoma benefit from metastatic tumor resection.However,operative timing should be further explored.